The Symptoms of Post Traumatic Stress Disorder: Re-experiencing, Avoidance and Hyperarousal

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Post traumatic stress disorder (PTSD), is a type of anxiety disorder that can affect people who have experienced a traumatic event. The National Alliance on Mental Illness notes that about 10 percent of women and 5 percent of men have been diagnosed with this disorder. To qualify for a diagnosis of PTSD, the patient must have “experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others” and the response to this traumatic event must have “involved intense fear, helplessness or horror,” according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).

The symptoms of PTSD fall into three categories: re-experiencing, avoidance and hyperarousal. Patients must have symptoms from each of these categories, which must last at least one month for a diagnosis to be made. If the duration of the symptoms are less than three months, it is considered acute PTSD, while if the duration of the symptoms are three months of more, it is considered chronic PTSD. The symptoms of PTSD include both psychological and physical symptoms.

Re-Experiencing Symptoms

The DSM-IV-TR includes five symptoms under the re-experiencing category for PTSD; patients must have at least one of these symptoms. For example, patients can have flashbacks of the event, in which they feel like they are living through the trauma again. The National Institute of Mental Health notes that flashbacks can be accompanied by physical symptoms, such as sweating. Children with PTSD may re-enact certain aspects of the trauma.

PTSD patients may have distressing dreams about the trauma and intrusive thoughts about the event may also occur. Besides causing a physical reaction, the re-experiencing of the traumatic event can also cause psychological distress in patients. These reactions can occur when exposed to something that can remind them of the trauma, such as a situation or an object.

Avoidance Symptoms

To meet the symptom criteria for PTSD, patients must meet at least three of the seven symptoms in the avoidance category. The DSM-IV-TR points out that these symptoms must not be present before the trauma in order to qualify as a symptom of PTSD. Avoidance symptoms include having problems remembering important details about the trauma and feeling detached from other people. PTSD patients may feel like they are emotionally numb, and they may have a restricted expression of their mood.

For example, patients may have depression, worry or guilt, and may avoid both thoughts and reminders of the event, which can include people, activities, places and objects. Symptoms also include a reduced interest in activities or reduced participation. PTSD patients may also feel like they have no future.

Hyperarousal Symptoms

The last category of PTSD symptoms is hyperarousal, of which patients must have two or more of the five described by the DSM-IV-TR to receive the diagnosis. Like the avoidance symptoms, these cannot be present before the trauma for a diagnosis to be made. The National Institute of Mental Health notes that the hyperarousal symptoms are not ones that are triggered by reminders, and they can occur on a regular basis. These symptoms include problems concentrating, hypervigilance and an exaggerated startle response. Sleep can also become affected; patients may have problems either falling asleep at night or they may have difficulty staying asleep throughout the night. Patients may also become irritable or have angry outbursts.